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Dr. Ralph Snyderman, Director of the Center for Personalized Health Care at Duke University, defines integrative medicine as a process that creates and encourages "a seamless engagement by patients and caregivers in the full range of physical, psychological, social, preventive, and therapeutic factors known to be effective and necessary for the achievement of optimal health over the course of one's life."<ref name="SnydermanInteg11">{{cite web |url=https://www.scripps.org/assets/documents/ralph_snyderman_md_03-30-11.pdf |format=PDF |title=Integrative Medicine: A Comprehensive Approach to Personalized Care |author=Snyderman, R. |work=Scripps Clinic Green Hospital Grand Rounds |date=30 March 2011 |accessdate=18 November 2021}}</ref> This type of personalized healthcare takes a more holistic approach to the causes of illnesses, including the biological, behavioral, psychosocial, and environmental contributors.<ref name="BravewellInteg15">{{cite web |url=https://bravewell.org/integrative_medicine/ |title=Integrative Medicine |publisher=The Bravewell Collaborative |date=2015 |accessdate=18 November 2021}}</ref> Some medical laboratories such as those found within Duke Integrative Medicine<ref name="BravewellDuke15">{{cite web |url=https://bravewell.org/current_projects/clinical_network/duke_center/ |title=Duke Integrative Medicine |publisher=The Bravewell Collaborative |date=2015 |accessdate=18 November 2021}}</ref>, as well as Harvard Medical School's Contemplative Neuroscience and Integrative Medicine Laboratory<ref name="HarvardCNIM20">{{cite web |url=https://davidvago.bwh.harvard.edu/contemplative-neuroscience-and-integrative-medicine-cnim-laboratory/ |title=Contemplative Neuroscience and Integrative Medicine (CNIM) Laboratory |work=David R. Vago - Brigham and Women's Hospital |publisher=Harvard Medical School |date=2020 |accessdate=18 November 2021}}</ref>, include an integrative medicine approach to their medical diagnostic and research activities. Laboratories associated with integrative medicine approaches are quite similar to standard medical laboratories, though, broadly speaking, they may focus more on nutritional, metabolic, and toxicity test types.<ref name="BralleyBasic">{{cite book |url=https://books.google.com/books?id=CpXVAwgOv7sC&pg=PT11 |chapter=Chapter 1: Basic Concepts |title=Laboratory Evaluations for Integrative and Functional Medicine |author=Bralley, J.A.; Lord, R.S. |publisher=MetaMetrix Institute |edition=2nd |pages=1–16 |year=2008 |isbn=0967394945}}</ref>
A public health laboratory is a type of medical laboratory that serves regional, national, or in some cases global communities by providing clinical diagnostic testing, environmental testing, disease diagnosis and evaluation, emergency response support, applied research, regulation and standards recommendations, laboratory training, and other essential services to the communities they serve.<ref name="BeckerAnIntro10">{{cite book |url=https://books.google.com/books?id=6SDqL72zPRUC |title=Public Health Laboratories: Analysis, Operations, and Management |chapter=Chapter 1: An Introduction to Public Health Laboratories |author=Becker, S.; Perlman, E.J. |editor=Jenkins, W. |publisher=Jones & Bartlett Learning |pages=1–14 |year=2010 |isbn=0763771023}}</ref><ref name="CommitteeTheGov03">{{cite book |url=https://books.google.com/books?id=qa8XYZQprt0C |title=The Future of the Public's Health in the 21st Century |chapter=Chapter 3: The Governmental Public Health Structure |author=Committee on Assuring the Health of the Public in the 21st Century, Board on Health Promotion and Disease Prevention |publisher=National Academies Press |pages=136–146 |year=2003 |isbn=0309133181}}</ref><ref name="APHLAbout">{{cite web |url=https://www.aphl.org/aboutAPHL/Pages/aboutphls.aspx |title=About Public Health Laboratories |publisher=Association of Public Health Laboratories |accessdate=18 November 2021}}</ref><ref name="BeckerPublic05">{{cite book |url=https://books.google.com/books?id=bFBPMcQe6ogC |title=Public Health Administration: Principles for Population-based Management |chapter=Chapter 27: Public Health Laboratory Administration |author=Becker, S.J.; Blank, E.C.; Martin, R.; Skeels, M. |editor=Novick, L.F.; Mays, G.P. |publisher=Jones & Bartlett Learning |pages=623–627 |year=2005 |isbn=0763740780}}</ref>  
 
A public health laboratory is unlike the average medical laboratory because it is "integrated into the broader public health system."<ref name="BeckerAnIntro10" /> The public health laboratory must typically meet more stringent requirements, including adhering to not only CLIA (for labs in the United States), but also additional regulations laid out by the departments, agencies, and other regulatory bodies of local, state, and/or national governments. Finally, the private medical laboratory focuses on tests that diagnose the diseases of individuals, while the functions of the public health laboratory serve entire populations.<ref name="BeckerAnIntro10" /><ref name="BeckerPublic05" />
 
A 2002 Association of Public Health Laboratories (APHL) report helped identify 11 core functions that state public health laboratories in the United States should accomplish, giving clearer insight into how the average public health laboratory in most parts of the world should operate. Note that this is not a guarantee every lab will perform these tasks, but it's a standard of what the lab should be responsible for doing. Those suggested 11 core functions are<ref name="MMWR2">{{cite journal |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5114a1.htm |title=Core Functions and Capabilities of State Public Health Laboratories |author=Witt-Kushner, J.; Astles, J.R.; Ridderhof, J.C. et al. |journal=Morbidity and Mortality Weekly Report |volume=51 |issue=RR14 |pages=1–8 |date=20 September 2002 |accessdate=18 November 2021}}</ref>:
 
* ''disease prevention, control, and surveillance'': provide timely and accurate analytical results for the assessment and surveillance of exposures; rapidly recognize and prevent the spread of communicable diseases; detect and identify biologic agents of significance in human disease; provide specialized tests for low-incidence, high-risk diseases;
* ''integrated data management'': accumulate, blend, and disseminate scientific [[information]] in support of public health programs; collect, monitor, and analyze laboratory data using national database systems; assist state epidemiologists, other laboratories, and practitioners with data needs
* ''reference and specialized testing'': serve as a primary reference microbiology laboratory for a wide variety of needs
* ''environmental health and protection'': conduct scientific analyses of potentially threatening environmental samples; detect, identify, and quantify toxic contaminants in environmental and biological specimens; provide air, water, soil, and other environmental laboratory testing services; provide environmental chemistry testing; determine the relationship between environmental hazards and human health; determine extent of a community's exposure to environmental hazards; provide industrial hygiene/occupational health testing
* ''food safety'': test specimens implicated in foodborne illness outbreaks to identify causes and sources; detect, identify, and quantify toxic contaminants in food specimens; monitor radioactive contamination of water, milk, shellfish, and other foods
* ''laboratory improvement and regulation'': coordinate and promote quality assurance programs in other laboratories; act as a standard and leader for other laboratories; develop and oversee quality assurance and laboratory improvement programs; oversee the licensure, certification, and accreditation of other laboratories
* ''policy development'': assist the development of state and federal public health policy; assist in the development of standards for all health-related laboratories
* ''emergency response'': provide laboratory support to state and national disaster preparedness plans and environmental or health emergencies
* ''public health-related research'': evaluate and implement new technologies and analytical methodologies in support of public health and healthcare communities; adapt emerging technologies to public health laboratories; conduct applied studies into new and improved analytical methods and services; assist the private sector with newly marketed tests
* ''training and education'': sponsor training opportunities for public health laboratory staff; provide or facilitate training and workshops for laboratory staff in private and public sectors; provide training opportunities for careers in public health laboratory practice; provide continuing education opportunities to staff
* ''partnerships and communication'': develop and strengthen partnerships among state, county, and city entities public and private; emphasize the role and value of the public health laboratory to state public health programs; participate in strategic policy planning and development processes; build and strengthen diverse communication networks


==References==
==References==
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{{Reflist|colwidth=30em}}

Revision as of 23:13, 21 January 2022

A public health laboratory is a type of medical laboratory that serves regional, national, or in some cases global communities by providing clinical diagnostic testing, environmental testing, disease diagnosis and evaluation, emergency response support, applied research, regulation and standards recommendations, laboratory training, and other essential services to the communities they serve.[1][2][3][4]

A public health laboratory is unlike the average medical laboratory because it is "integrated into the broader public health system."[1] The public health laboratory must typically meet more stringent requirements, including adhering to not only CLIA (for labs in the United States), but also additional regulations laid out by the departments, agencies, and other regulatory bodies of local, state, and/or national governments. Finally, the private medical laboratory focuses on tests that diagnose the diseases of individuals, while the functions of the public health laboratory serve entire populations.[1][4]

A 2002 Association of Public Health Laboratories (APHL) report helped identify 11 core functions that state public health laboratories in the United States should accomplish, giving clearer insight into how the average public health laboratory in most parts of the world should operate. Note that this is not a guarantee every lab will perform these tasks, but it's a standard of what the lab should be responsible for doing. Those suggested 11 core functions are[5]:

  • disease prevention, control, and surveillance: provide timely and accurate analytical results for the assessment and surveillance of exposures; rapidly recognize and prevent the spread of communicable diseases; detect and identify biologic agents of significance in human disease; provide specialized tests for low-incidence, high-risk diseases;
  • integrated data management: accumulate, blend, and disseminate scientific information in support of public health programs; collect, monitor, and analyze laboratory data using national database systems; assist state epidemiologists, other laboratories, and practitioners with data needs
  • reference and specialized testing: serve as a primary reference microbiology laboratory for a wide variety of needs
  • environmental health and protection: conduct scientific analyses of potentially threatening environmental samples; detect, identify, and quantify toxic contaminants in environmental and biological specimens; provide air, water, soil, and other environmental laboratory testing services; provide environmental chemistry testing; determine the relationship between environmental hazards and human health; determine extent of a community's exposure to environmental hazards; provide industrial hygiene/occupational health testing
  • food safety: test specimens implicated in foodborne illness outbreaks to identify causes and sources; detect, identify, and quantify toxic contaminants in food specimens; monitor radioactive contamination of water, milk, shellfish, and other foods
  • laboratory improvement and regulation: coordinate and promote quality assurance programs in other laboratories; act as a standard and leader for other laboratories; develop and oversee quality assurance and laboratory improvement programs; oversee the licensure, certification, and accreditation of other laboratories
  • policy development: assist the development of state and federal public health policy; assist in the development of standards for all health-related laboratories
  • emergency response: provide laboratory support to state and national disaster preparedness plans and environmental or health emergencies
  • public health-related research: evaluate and implement new technologies and analytical methodologies in support of public health and healthcare communities; adapt emerging technologies to public health laboratories; conduct applied studies into new and improved analytical methods and services; assist the private sector with newly marketed tests
  • training and education: sponsor training opportunities for public health laboratory staff; provide or facilitate training and workshops for laboratory staff in private and public sectors; provide training opportunities for careers in public health laboratory practice; provide continuing education opportunities to staff
  • partnerships and communication: develop and strengthen partnerships among state, county, and city entities public and private; emphasize the role and value of the public health laboratory to state public health programs; participate in strategic policy planning and development processes; build and strengthen diverse communication networks

References

  1. ↑ 1.0 1.1 1.2 Becker, S.; Perlman, E.J. (2010). "Chapter 1: An Introduction to Public Health Laboratories". In Jenkins, W.. Public Health Laboratories: Analysis, Operations, and Management. Jones & Bartlett Learning. pp. 1–14. ISBN 0763771023. https://books.google.com/books?id=6SDqL72zPRUC. 
  2. ↑ Committee on Assuring the Health of the Public in the 21st Century, Board on Health Promotion and Disease Prevention (2003). "Chapter 3: The Governmental Public Health Structure". The Future of the Public's Health in the 21st Century. National Academies Press. pp. 136–146. ISBN 0309133181. https://books.google.com/books?id=qa8XYZQprt0C. 
  3. ↑ "About Public Health Laboratories". Association of Public Health Laboratories. https://www.aphl.org/aboutAPHL/Pages/aboutphls.aspx. Retrieved 18 November 2021. 
  4. ↑ 4.0 4.1 Becker, S.J.; Blank, E.C.; Martin, R.; Skeels, M. (2005). "Chapter 27: Public Health Laboratory Administration". In Novick, L.F.; Mays, G.P.. Public Health Administration: Principles for Population-based Management. Jones & Bartlett Learning. pp. 623–627. ISBN 0763740780. https://books.google.com/books?id=bFBPMcQe6ogC. 
  5. ↑ Witt-Kushner, J.; Astles, J.R.; Ridderhof, J.C. et al. (20 September 2002). "Core Functions and Capabilities of State Public Health Laboratories". Morbidity and Mortality Weekly Report 51 (RR14): 1–8. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5114a1.htm. Retrieved 18 November 2021. 
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